{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:03:34Z","timestamp":1790024614120,"version":"4.0.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>There is no ideal treatment paradigm for paralytic ectropion. This study evaluated lower eyelid spacers and the efficacy of a novel lower eyelid thin profile, bio-integratable, porous polyethylene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of 15 consecutive patients who underwent thin-profile porous polyethylene implantation and canthoplasty for paralytic ectropion was carried out. A comprehensive literature review of spacers for paralytic ectropion and retraction using the Pubmed database with search terms \u201c[implant or graft or spacer] and [paralytic ectropion or paralytic retraction],\u201d \u201cgraft and paralysis and ectropion,\u201d \u201cimplant and paralysis and ectropion,\u201d \u201cgraft and paralysis and retraction,\u201d and \u201cimplant and paralysis and retraction\u201d was carried out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean patient age was 69 years (range: 50\u201388). Lagophthalmos improved from a mean of 5.7 mm (SD = 3.3, range 3\u201314 mm) to 1.4 mm (SD = 1.1, range 0\u20133.5 mm),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001. MRD 2 improved from a mean of 6.7 mm (SD = 2.3, range 2\u201312 mm) to 4.2 mm (SD = 0.9, range 3\u20136 mm),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0005. No patients needed additional lower eyelid surgery. There were no implant exposures at a mean follow-up of 7.6 months (SD = 7.9, range 0.7\u201321.6 months). Detailed literature review revealed that hard palate and ear cartilage are the most reported spacers, each with unique disadvantages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The thin-profile porous polyethylene implant is a useful addition to the management of symptomatic paralytic ectropion. Meaningful comparison of lower eyelid spacers is difficult because of variations in surgical technique, spacer size, and poorly reported outcome data. No spacer proves superior.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_885_22","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T09:22:50Z","timestamp":1675329770000},"page":"444-451","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Implants and spacers for paralytic ectropion: Literature review and assessment of a thin-profile porous polyethylene implant"],"prefix":"10.4103","volume":"71","author":[{"given":"Alomi O","family":"Parikh","sequence":"first","affiliation":[{"name":"University of Southern California, Roski Eye Institute, Department of Ophthalmology, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret L","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"University of Southern California, Roski Eye Institute, Department of Ophthalmology, Los Angeles, CA, USA"},{"name":"Eyesthetica, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindi K","family":"Yim","sequence":"additional","affiliation":[{"name":"University of Southern California, Roski Eye Institute, Department of Ophthalmology, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Burnstine","sequence":"additional","affiliation":[{"name":"University of Southern California, Roski Eye Institute, Department of Ophthalmology, Los Angeles, CA, USA"},{"name":"Eyesthetica, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"R1-20251006","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/asj\/sjx003","article-title":"Comparison of efficacy and complications among various spacer grafts in the treatment of lower eyelid retraction:A systematic 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